Trial reportThe Journal of clinical endocrinology and metabolism2024
Poor Glycemic Control Is Associated With More Rapid Kidney Function Decline After the Onset of Diabetic Kidney Disease.
Trial report in The Journal of clinical endocrinology and metabolism, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Long-term effects of adding an SGLT-2 inhibitor to insulin therapy in patients with type 1 diabetes. An observational study and systematic review of real-world evidence.Journal of endocrinological investigation · 2025Pooled it
- Harnessing Machine Learning, a Subset of Artificial Intelligence, for Early Detection and Diagnosis of Type 1 Diabetes: A Systematic Review.International journal of molecular sciences · 2025Pooled it
- Impact of Simultaneous Initiation of Finerenone and Empagliflozin on Albuminuria Irrespective of Baseline HbA1c Levels: A Participant-Level Exploratory Analysis of the Randomised CONFIDENCE Trial.Diabetes, obesity & metabolism · 2026Trial
- Effect of Finerenone on Albuminuria in Type 1 Diabetes by Baseline HbA1c Level and Diabetes Duration: An Exploratory Analysis of the FINE-ONE Trial.Diabetes care · 2026Trial
- Poor Glycemic Control Is Associated With More Rapid Kidney Function Decline After the Onset of Diabetic Kidney Disease.The Journal of clinical endocrinology and metabolism · 2024Trial
- Association of 14-day continuous glucose monitoring-derived postprandial hyperglycemic area with 6-month change in urinary albumin-to-creatinine ratio in patients with newly diagnosed type 2 diabetes mellitus.Frontiers in endocrinology · 2026Article
- Association between islet β-cell function and time in range in patients with type 2 diabetes mellitus: a retrospective cross-sectional study.Frontiers in endocrinology · 2026Observational
- Addressing unmet needs for chronic kidney disease treatment in type 1 diabetes: A review.Diabetes, obesity & metabolism · 2026Review
- Glycemic index of some protein-free food products for individuals with non-dialysis-dependent chronic kidney disease.Nutrition & metabolism · 2025Article
- Predicting rapid decline in kidney function among type 2 diabetes patients: A machine learning approach.Heliyon · 2025Article
- A Machine Learning Model for Predicting Diabetic Nephropathy Based on TG/Cys-C Ratio and Five Clinical Indicators.Diabetes, metabolic syndrome and obesity : targets and therapy · 2025Article
- Immune-mediated renal injury in diabetic kidney disease: from mechanisms to therapy.Frontiers in immunology · 2025Review
- Risk factors for rapid kidney function decline in diabetes patients.Renal failure · 2024Review
- Good metabolic control is associated with decreased circulating factor VIIa- antithrombin complexes in type 2 diabetes: a cross-sectional study.Cardiovascular diabetology · 2024Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundThe role of glycemic control and its variability on the rate of kidney function decline after the onset of diabetic kidney disease (DKD) remains unclear.
methodsThe association between baseline glycated hemoglobin (HbA1c) and rates of estimated glomerular filtration rate (eGFR) loss during follow-up was examined by mixed-effects linear regression in 530 individuals with type 1 diabetes and early-to-moderate DKD from the Preventing Early Renal Loss (PERL) trial and 2378 individuals with type 2 diabetes and established DKD from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. The benefit of intensive vs standard glycemic control in slowing eGFR decline was examined in ACCORD. The associations between continuous glucose monitoring-derived short-term glycemic variability indices and rate of eGFR decline were also evaluated in PERL.
resultsA higher baseline HbA1c was associated with a more negative eGFR slope in both PERL and ACCORD (-0.87 and -0.27 mL/min/1.73 m2/year per Hba1c unit increment, P < .0001 and P = .0002, respectively). In both studies, the strength of this association progressively increased with increasing levels of albuminuria (P for interaction <.05). Consistent with this, the benefit of intensive glycemic control on eGFR decline was greater in ACCORD participants with severe rather than moderate albuminuria (+1.13 vs + 0.26 mL/min/1.73 m2/year, P = .01). No independent associations were found in PERL between short-term glycemic variability indices and rate of eGFR decline.
conclusionIn both type 1 and type 2 diabetes, poor glycemic control is associated with a more rapid rate of glomerular filtration rate decline after DKD onset, especially in persons with severe albuminuria.
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